Digital health is a promising development in the pursuit of patient centered care. Technological developments, like patient portals, are providing new opportunities for patients to engage in their own healthcare journeys, increasing access to health data and practitioners in many cases. The primary objective of this research is the establishment of an in-patient portal for a new children’s hospital through a collaborative design process. This paper details experiences from the first phase of this multi-year project and in particular methodological solutions that have been developed in order to meet the challenges of engaging acute care patients, families, and practitioners in user-centered design within such a demanding context.